Alcohol abuse is associated with injury, chronic illness, absenteeism from work, and social costs to families and communities. The goal of this project is to translate motivational interventions successful in the primary care setting to the Emergency Department (ED) environment by implementing screening, brief intervention and referral to treatment (SBIRT) in order to reduce at-risk drinking among ED patients. The UCONN Health Center seeks to participate in this project as the Data Coordinating Center (DCC) for a National Alcohol Screening Day (NASD) focused, multi-center study designed to test the feasibility and effectiveness of (SBIRT) as practiced by ED nurses and physicians as part of clinical care in the ED setting. Approximately 250 patients from each ED site will be screened for risky drinking during the 2 weeks accompanying NASD 2004, with those scoring positive (approximately 50 at each site) offered a brief motivational intervention targeting alcohol use. An additional 250 patients at each site will be screened during 2 weeks in February 2004; those screening positive (approx. 50) will receive only a printed handout of alcohol resources but will not receive the brief intervention. These procedures are expected to yield an initial sample of approximately 1000 patients across 10-12 ED sites. Three and six months following their ED visits patients in both the treatment and control conditions will complete follow-up interviews by telephone using Interactive Voice Response (IVR) technology. Primary outcomes assessed include drinking behavior and alcohol related health consequences (e.g., drunken driving, fights, etc.). Analysis of these data using statistical procedures that adjust for the nesting of patients within hospital sites is expected to show significant decreases in the quantity and frequency of drinking and in negative consequences of alcohol use among patients receiving SBIRT relative to controls. Results from this study will inform the investigators, clinical staff, and the scientific community about the effectiveness of a brief negotiated interview as a behavioral intervention to decrease at-risk alcohol consumption among patients in the ED setting.